- |||||||||| levofloxacin / Generic mfg., amikacin sulfate / Generic mfg.
Severe Cystic Pulmonary Tuberculosis: A Rare Presentation in the United States (San Diego Convention Center, Area H (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_4138;
Her course was also complicated by multiple superimposed bacterial pneumonias, continued respiratory failure requiring tracheostomy, malnutrition requiring TPN, and persistent AFB positive sputum requiring addition of levofloxacin and amikacin. Though severe cystic lung disease caused by tuberculosis is rarely encountered, a high level of suspicion is required for rapid diagnosis and treatment to prevent mortality.
- |||||||||| Endemic Dangers: A Rare Case of Dual Infection With Legionella and Blastomycosis Requiring Veno-venous Extracorporeal Membrane Oxygenation (San Diego Convention Center, Area H (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_4086;
Case:A 51-year-old immunocompetent female with BMI 40, mild intermittent asthma, and relapsing-remitting multiple sclerosis (not requiring treatment) presented with worsening pneumonia despite outpatient treatment with cefdinir, azithromycin, amoxicillin-clavulanic acid, and methylprednisolone...She was treated with levofloxacin and amphotericin B and was able to successfully decannulate on HD 8...1% but can remain positive as long as 300 days. In summary, this case of coinfection with Blastomycosis and Legionella poses interesting challenges in pulmonary infection diagnostics and serves as a reminder about the risks of endemic pneumonias.
- |||||||||| levofloxacin / Generic mfg., azithromycin / Generic mfg.
Legionella Pneumonia With Rhabdomyolysis With Extremely High Creatine Phosphokinase (CPK) Without Acute Kidney Injury (AKI) (San Diego Convention Center, Area H (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_4081;
Azithromycin was changed to Levofloxacin on day 5 due to possible rare treatment failure as the patient showed minimal improvement. LP with rhabdomyolysis with extremely high CPK levels is usually associated with AKI but preserved kidney function is possible and early diagnosis and treatment can lead to decreased mortality and morbidity in severe disease.
- |||||||||| bamlanivimab (LY-CoV555) / Eli Lilly, AbCellera, National Institute of Allergy and Infectious Diseases
Organizing Pneumonia With Surgical Pathology Positive for SARS-CoV2 a Year After Initial COVID-19 Diagnosis Despite Negative COVID-19 PCR From Nasal Swabs and Bronchial Alveolar Lavage in a Lymphopenic Cancer Patient (San Diego Convention Center, Area H (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_4077;
He received monoclonal antibody, Bamlanivimab, with little improvement...Given symptoms, negative infectious work up including fungal markers and PET scan with new bilateral ground glass opacities (GGOs), he was started on prednisone 10mg daily for presumed long COVID-19...He tested COVID PCR negative multiple times and was treated for presumed pneumonia with Augmentin and Levofloxacin with minimal improvement in symptoms...While COVID PCR from a BAL has high sensitivity, the patient tested negative multiple times with the diagnosis ultimately made with immunohistochemical stains from biopsy. Steroids continue to be the treatment of choice for PCOP.
- |||||||||| Dupixent (dupilumab) / Sanofi, Regeneron
Dupilumab-Induced Hyper-Eosinophilia: A Call for Treatment Guideline (San Diego Convention Center, Area D (Hall A-B2, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_3796;
04 mcg/min and hydrocortisone 50 mg every 6 hours (MAP >65mmHg)...This case highlights the importance of steroids in resolving dupilumab-induced hyper-eosinophilia and its sequelae including possibly anaphylaxis4. In short, more research is needed to guide monitoring, classifying the severity of dupilumab-induced hyper-eosinophilia, and a consensus on treatment.
- |||||||||| Fetroja (cefiderocol) / Shionogi, Mycamine (micafungin) / Astellas
The Deadly Duel: Legionnaires Disease and Multiple Myeloma: A Case of Fatal Pulmonary Renal Syndrome (San Diego Convention Center, Area E (Hall A-B2, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_3545;
Sputum cultures grew multidrug-resistant Klebsiella and Acinetobacter sensitive to cefiderocol prompting discontinuation of meropenem, vancomycin, and levofloxacin after starting cefiderocol...Steroids, which are indicated in acute respiratory disease, preserve renal function by reducing inflammation, thus avoiding the need for hemodialysis. However the use of steroids has yet to be fully studied.
- |||||||||| cefazolin / Generic mfg., levofloxacin / Generic mfg., oseltamivir / Generic mfg.
Epididymo-orchitis Associated With Covid-19 Infection in a Young Male (San Diego Convention Center, Area E (Hall A-B2, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_3524;
The patient was also treated with oseltamivir for 10 days...The patient was put on prophylactic levofloxacin 500mg daily, however he reported complete resolution of his symptoms within 3 days...However, cases of documented epididymo-orchitis with ultrasound findings are rare. Recognition of this association can lead to accurate diagnosis and prevent undue intervention.
- |||||||||| levofloxacin / Generic mfg.
Legionnaire's Disease Presenting With Combined Neurologic and Cardiac Involvement (San Diego Convention Center, Area E (Hall A-B2, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_3515;
With IV levofloxacin, antiepileptics, intravenous immunoglobulins and diuretics, the patient's condition improved...We present a unique case of Legionnaire's disease with serious combined neurologic and cardiac complications. Respiratory tract infections accompanied by multisystemic involvement should prompt consideration and treatment of Legionnaire's disease.
- |||||||||| Mycamine (micafungin) / Astellas, Humira (adalimumab) / AbbVie
A Rare Case of Necrotizing Pneumonia in an Immunocompromised Patient (San Diego Convention Center, Area I (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_2012;
While this patient's progressive hypoxic respiratory failure was multifactorial including from S. pneumoniae and COVID-19 pneumonia, his rapidly progressive necrotizing pneumonia was likely secondary to L. micdadei. Early diagnosis and treatment of L. micdadei is challenging yet essential, particularly in immunosuppressed patients, as this bacterium has statistically higher mortality rates than other causes of nosocomial pneumonia.
- |||||||||| piperacillin sodium/tazobactam sodium / Generic mfg., levofloxacin / Generic mfg.
Salmonella Pneumonia and Empyema in a Patient with End - Stage Liver Disease (San Diego Convention Center, Area I (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_2005;
Patient was started on Piperacillin-tazobactam...Patient was subsequently transitioned to oral levofloxacin with a 2 month treatment course as well as regular follow up with pulmonology and infectious disease...Source control via chest tube or surgical intervention are necessary. A multidisciplinary approach is important when diagnosing and treating an empyema.
- |||||||||| Pulmonary Nocardiosis in an Asthmatic Patient on Inhaled Corticosteroid (ICS) Therapy: Is ICS Use a Risk Factor? (San Diego Convention Center, Area I (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1987;
amikacin, carbapenems, third-generation cephalosporins, levofloxacin, minocycline, and amoxicillin-clavulanic acid are second-line and other effective agents used for the treatment of Pulmonary Nocardiosis...Clinical suspicion holds significant importance, as it necessitates specific microbiological tests. The management of nocardiosis often entails prolonged and occasionally combined therapies.
- |||||||||| Culture Negative Infective Endocarditis Secondary to Septic Emboli of Lung (San Diego Convention Center, Area I (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1982;
Case:32-year-old female with underlying DM, HTN,hypothyroidism, IVDU, polysubstance abuse, chronic smoker,medication non-compliance presenting to the ED for right sided chest pain since overdosed on fentanyl 1...UDS: + Amphetamine...The ID team initially recommended Ceftriaxone, metronidazole, vancomycin, Amphotericin B, then switched to Doxycycline and fluconazole...Patients with suspected lung abscess from aspiration, empiric antibiotics that penetrate the lung parenchyma and target both strict anaerobes and facultatively anaerobic streptococci: beta-lactam/beta-lactamase inhibitor for most patients or a carbapenem because of rising penicillin resistance rates among anaerobes, For patients who cannot use beta-lactams, monotherapy with clindamycin, moxifloxacin, or combination therapy with levofloxacin plus metronidazole are reasonable alternatives...Illicit drugs are widely consumed by an increasing number of persons, correct diagnosis and appropriate treatment planning in the presence of respiratory manifestations require familiarity with the wide spectrum of morbidities and pulmonary dangers associated with their abuse. Aspiration pneumonia and CAP probably represent the most common complications
- |||||||||| Polymicrobial Empyema - The Unusual Suspects (San Diego Convention Center, Area I (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1975;
Patients with chronic illnesses associated with immunossupression are at a higher risk for complicated infections, particularly due to drug-resistant and multiple microbes, requiring broad spectrum antibiotic coverage. This case illustrates the relevance of anaerobic and aerobic culture media for the microbiologic diagnosis of empyema, with the particularity of an uncommon growth of a rare Clostridia species.
- |||||||||| A Rare Case of Bordetella Bronchiseptica Pneumonia in a Viral-Suppressed Human Immunodeficiency Virus (HIV) Patient With a Normal CD4 Count (San Diego Convention Center, Area I (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1971;
While Bordetella bronchiseptica is commonly observed in immunocompromised individuals, cases of pulmonary infection in immunocompetent patients highlight the diagnostic challenges, treatment approach, and clinical outcome if not recognized early. Given the significant morbidity and mortality with unrecognized infections, our case highlights the importance of considering this zoonotic respiratory pathogen in susceptible patients with a history of exposure.
- |||||||||| prednisone / Generic mfg., levofloxacin / Generic mfg., methotrexate / Generic mfg.
Genitourinary Tuberculosis Resulting in Hydronephrosis (San Diego Convention Center, Area I (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1922;
This is a case presentation of a patient with immunocompromise secondary to treatment for rheumatoid arthritis on methotrexate and chronic prednisone who was diagnosed with genitourinary tuberculosis...He was treated with isoniazid 300 mg daily x 6 months, Rifampin 600 mg daily x 6 months, pyrazinamide 1500 mg daily x 2 months, ethambutol 1200 mg daily x 2 months, and pyrodoxine 50 mg daily x 6 months that was changed to levofloxacin 750 daily, ethambutol, pyrazinamide and rifampin when sensitivities showed resistance to isoniazid...8% of tuberculosis cases, 68 persons, was a genitourinary diagnosis(1) out of a total case reported of 7,882(2). This presentation is to help to increase awareness of the diagnosis for earlier diagnosis.
- |||||||||| levofloxacin / Generic mfg., rifampicin / Generic mfg.
Characterazing Multidrug- Resistant Tuberculosis (MDR-TB) in Madagascar: A Real Threat to Health Security (San Diego Convention Center, Area I (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1910;
Tuberculosis(TB) is a public health issue and MDR-TB (resistant to Isoniazid (H) and Rifampicin (R) is recognized as a health crisis by the World Health Organization (WHO)...Both of the H resistant patients were unsuccessfully treated with the protocol RHEZLevofloxacin for 6 months...Actually, the WHO in its global TB 2022 indicates the reduction of TB case notifications including DR-TB ,during the Covid19 pandemic. LIMITS OF OUR STUDYIn this study , risk factors were not shown CONCLUSION In Madagascar, a low income country,TB resistance must be considered as a health crisis, a threat:a priority needing an efficient national program .
- |||||||||| Rituxan (rituximab) / Roche
Pediatric Diffuse Lung Disease Leading to Recurrent Respiratory Failure (San Diego Convention Center, Area J (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1880;
The BAL culture grew Pseudomonas and he was treated with Levofloxacin...Treatment included daily steroids, rituximab, and azathioprine, with continued antimicrobials...Pattern recognition for the spectrum of lymphoproliferative disorders of the lung in the setting of unclear diagnosis is essential to choosing immunomodulation. Therefore, we used an immunomodulatory regimen used for granulomatous interstitial lung disease, an ILD with similar pathology consistent with that seen in this patient.
- |||||||||| A Rare Presentation of Hydropneumothorax in a Previously Healthy Adolescent (San Diego Convention Center, Area J (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1822;
There are no established guidelines for management of hydropneumothorax and this case demonstrated a complicated course not completely responsive to chest tube evacuation or straightforward VATS. Surgical intervention, specifically decortication of the restrictive rind, was necessary to see clinical improvement.
- |||||||||| levofloxacin / Generic mfg., rifampicin / Generic mfg., mycophenolate mofetil / Generic mfg.
Interstitial Pneumonia With Autoimmune Features Mimicking Paradoxical Responses in a Patient Under Treatment for Tuberculosis: A Case Report (San Diego Convention Center, Area C (Hall A-B2, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1653;
Treatment involved a modified anti-tuberculosis drug regimen which included rifampicin, levofloxacin, and ethambutol, as he experienced INH-induced psychosis...Subsequently, he was treated with Mycophenolate mofetil at 500 mg twice daily, escalated to 2g/day, coupled with glucocorticoids...Discussing the risks and benefits of immunomodulatory drugs in patients with tuberculosis is crucial. Early diagnosis and treatment of IPAF conditions significantly enhance the patient's quality of life and overall outcomes.
- |||||||||| levofloxacin / Generic mfg., cyclophosphamide / Generic mfg., cyclosporine / Generic mfg.
Unmasking the Rash and Breathlessness Puzzle: A Dermatopulmonary Conundrum (San Diego Convention Center, Area A (Hall A-B2, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1564;
He had previously undergone treatment for suspected pneumonia with levofloxacin without improvement in symptoms...Treatment involves intense immunosuppression and includes a combination of high dose glucocorticoids, cyclophosphamide, tacrolimus, cyclosporine and plasmapheresis...The combination of skin changes and diffuse parenchymal lung disease should prompt investigation into possible ILD, specifically dermatomyositis. Early recognition of this disease is pivotal as treatment delays can result in significant morbidity and mortality.
- |||||||||| levofloxacin / Generic mfg.
Lip and Cheek: Sjogren's Syndrome Complicated by Lymphocytic Interstitial Pneumonia and Parotid Mucosal Associated Lymphoid Tissue Lymphoma (San Diego Convention Center, Area A (Hall A-B2, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1535;
The patient had been started on levofloxacin for five days for presumed community acquired pneumonia with mild improvement in the cough...DiscussionIdiopathic LIP is very rare and acquired LIP often occurs in Castleman's Syndrome, acquired immunodeficiency syndrome, or Sjrogen's Syndrome2. In this patient, an immunologic workup was coincidentally completed to investigate unilateral parotid gland enlargement which led to a new diagnosis of Sjogren's Syndrome with subsequent parotid biopsy identifying a related Non-Hodgkin's lymphoma3.
- |||||||||| levofloxacin / Generic mfg.
Slowly Resolving Pneumonia in Primary Care Setting: Interstitial Lung Disease Associated With Antisynthetase Syndrome: A Case Report (San Diego Convention Center, Area A (Hall A-B2, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1529;
The patient was initially treated for OP with Levofloxacin (750 mg/day) and Prednisolone (1 mg/kg)...Primary care clinicians must be aware of this syndrome as it can often present with rapidly progressing ILD, the principal mediator of morbimortality in these patients. It is essential to carry out studies and discuss cases of uncommon diseases such as AS to promote knowledge about the clinical presentation and diagnostic modalities to accomplish timely management of the disease in the primary care setting.
- |||||||||| Elizabethkingia Meningoseptica Pneumonia and Bacteremia With Septic Shock: A Case Report (San Diego Convention Center, Area K (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_1227;
Interestingly, starting with less heavy-handed antimicrobials, i. e. the "less is more" principle may have been beneficial: levofloxacin would have covered ESBL organisms and possibly averted Elizabethkingia meningoseptica bacteremia. Overall, we present a rare case of resolution of Elizabethkingia meningoseptica from the blood and respiratory system using aggressive targeted combination therapy.
- |||||||||| Rituxan (rituximab) / Roche
Unmasking of Connective Tissue- Interstitial Lung Disease (ILD) Following COVID-19 Infection (San Diego Convention Center, Area D (Hall A-B2, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_969;
Respiratory cultures were positive for Mycoplasma pneumonia, for which she was treated with piperacillin-tazobactam inpatient and later discharged on levofloxacin to complete a ten day course...She was started on Cellcept with a prednisone taper, with significant improvement in both respiratory and myopathy symptoms...At this point, the patient was diagnosed with CT-ILD and rituximab was added to her treatment plan...It is also implicated in the cytokine storm noted in COVID-19. In our patient with no previous history of myopathy or subtle signs significant for polymyositis, it begs the question: Did COVID-19 and it's related IL-6 and cytokine storm unmask the symptoms of a previously present inflammatory myopathy, or was it the precipitating cause for the development of her polymyositis and related ILD?
- |||||||||| Psoralen / EMD Serono
Journal: Discovery of psoralen as a quorum sensing inhibitor suppresses Pseudomonas aeruginosa virulence. (Pubmed Central) - Feb 19, 2024
In our patient with no previous history of myopathy or subtle signs significant for polymyositis, it begs the question: Did COVID-19 and it's related IL-6 and cytokine storm unmask the symptoms of a previously present inflammatory myopathy, or was it the precipitating cause for the development of her polymyositis and related ILD? Moreover, psoralen showed synergistic antibacterial effects with polymyxin B, levofloxacin, and kanamycin.
- |||||||||| apramycin (EBL-1003) / Juvabis
Journal: P-type ATPase zinc transporter Rv3270 of Mycobacterium tuberculosis enhances multi-drug efflux activity. (Pubmed Central) - Feb 19, 2024
Of note, the expression of Rv3270 enhanced the biofilm-forming ability of the host cells strengthening its role in antimicrobial resistance. Therefore, the study indicated that the over-expression of Rv3270 enhances the drug efflux activity of the micro-organism where zinc might facilitate drug-metal cross-resistance for some antibiotics.
- |||||||||| levofloxacin / Generic mfg., ceftazidime / Generic mfg.
Journal: Three-Year Point Prevalence Survey of Antimicrobial Use in a Chinese University Hospital. (Pubmed Central) - Feb 16, 2024
The PPS tool is useful in identifying targets to enhance the quality of antimicrobial prescriptions to improve the adherence rate in hospitals. This survey can be used as a control to assess the rational application quality of antimicrobial after regular application of antimicrobial intervention.
- |||||||||| Journal: Susceptibility and Synergistic Effects of Guava Plant Extract and Antimicrobial Drugs on Escherichia coli. (Pubmed Central) - Feb 16, 2024
This finding indicates that guava extract enhances the effectiveness of commonly used antibiotics for treating UTI, an effect mainly attributed to the flavonoid compounds and their derivatives in the guava leaf extract, which inhibit bacterial growth. This study demonstrated the antibacterial properties of guava, suggesting that combining antibiotics with guava extract can help delay the emergence of bacterial resistance.
- |||||||||| levofloxacin / Generic mfg., epinephrine / Generic mfg.
Phase classification, Trial completion date, Trial primary completion date: MIXCRYO: Pain and Microbial Reduction of Antimicrobial Corticosteroid Mixture Versus Cryotherapy in Necrotic Teeth (clinicaltrials.gov) - Feb 15, 2024
P=N/A, N=28, Not yet recruiting,
This study demonstrated the antibacterial properties of guava, suggesting that combining antibiotics with guava extract can help delay the emergence of bacterial resistance. Phase classification: P3 --> P=N/A | Trial completion date: Dec 2023 --> Dec 2024 | Trial primary completion date: Dec 2023 --> Aug 2024
- |||||||||| vancomycin / Generic mfg., levofloxacin / Generic mfg., tigecycline / Generic mfg.
Journal: Distribution and Antibiotic Resistance Analysis of Ocular Bacterial Pathogens at a Tertiary Hospital From 2012 to 2021 (Pubmed Central) - Feb 11, 2024
Staphylococcus epidermidis isolated from patients with external eye infections had a low rate of resistance to levofloxacin (2/27 or 7.41%), whereas those isolated from patients with endophthalmitis had a higher resistance rate (43/127 or 33.86%)...The Staphylococcus epidermidis identified in the hospital had a high rate of resistance to oxacillin, but remained highly sensitive to vancomycin, linezolid, and tigecycline...However, the establishment of the breakpoint of drug susceptibility test is mainly based on the model of bloodstream infection and has limited reference value for the treatment of eye infection. The required drug distribution concentration at the infection site can be achieved by dose increase or local administration.
- |||||||||| ciprofloxacin oral / Generic mfg., levofloxacin / Generic mfg., fluconazole oral / Generic mfg.
Journal: Lactoferricin B Combined with Antibiotics Exhibits Leukemic Selectivity and Antimicrobial Activity. (Pubmed Central) - Feb 10, 2024
In this study, we revisited and reanalyzed our earlier research on LfcinB and its conjugates. Furthermore, we carried out new experiments with a specific focus on cell proliferation, changes in membrane asymmetric phosphatidylserine location, intracellular reactive oxygen species (ROS) generation, mitochondrial functions, and in vitro bacterial topoisomerase inhibition.
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